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UNDERGROUP'V ' K PROGRAM OFFICIAL INSP"':T''`)N REPORT JOAQUIN HEALTH DISTRICT N G _ 1601 E. HAZELA 9 AVE. C�Y `,/) (/5�/Cj STOCKTON, CA 95205 Cou�y # PHONE NO. 468-3423 SITE NAME: )(V' INSPECTION DATE::�L" 7-# SITE ADDRESS: ./�� e"h? -� CITY/STATE/ZIP' C RANGES SITE/OWNER-/'PERMIT? YES O TANK TANK TANK TANK ORM A AND/OR B SUBMITTED? 5' COMPUTER COMPUTER COMPUTER COMPUTER NUMBER NUMBER NUMBER NUMBER OF INSPECS COMPUTER# PER# PER# PER# PER# 'V EXP.DATE EXP.DATE EXP.DATE EXP.DATE TANK CONTENT8 R � �Y A OPERATIONA TANK MAJOR MINOR PERMIT TO OPERATE 1 2 CHANGE IN CONDITIONS TO OPERATE 3 4 APPROVED CONSTRUCTION 5 B WRITTEN MONITORING PROCEDURES 7 18 APPROVED MONITORING SYSTEM 9 110 MONITORING SYSTEM 11 112 APPROVED MONITOR FREQUENCY 13 114 1 MONITORING RECORDS MAINTAINED 15 116 _ ACCESS CASING SECURED 17 118 PIPING 19 20 INVENTORY RECONCILIATION 21 22 TANK GAUGING 23 24 ------- _ ___ _ APPROVED RESPONSE PLAN 25 26 _ _._,_.—-_..._ UNAUTHORIZED RELEASE OCCURRENCE 27 28 SAMPLING 29 APPROVED TANK REPAIRS 31 32 _ UNAUTHORIZED RELEASES REPORTED 33 34 SAFETY HAZARD 35 36 CONDITIONS ABATED 37 TEMPORARY TANK CLOSURE N=r ,.'j i REMOVAL OF RESIDUAL 38 39 FLAMMABLE VAPORS REMOVED 40 ACCESS LOCATIONS SEALED 41 42 POWER DISCONNECTED 43 OWNER/OP MONITORING 44 45 PERMANENT TANK CLOSURE z REMOVAL SIDUAL MATERIALS 46 47 _ _.__._. _._._. 48 49 PIPING FLAMMABLE VAPORS REMOVED 50 UNAUTHORIZED RELEASE 51 SAMPLING 53 54 IMPROPER ABANDONMENT 55 56 THE MARKED ITEMS REPR SE T V!O ONS AND MUST BE CORRECTED AS SYSTEM STATUS(MUST)MARK ONE) FOLLOWS: MAJOR 57 MINOR NO VIOL, Li VIOL ❑ VIOL58 5 OFFICE: INSP:vim f RECEIVED BY: TITLE: PHONE: BECK: 5!88 O HUT-3 ORIGINAL